agent 59 - dawn user group presentation · “agent 59: improving patient experience through...
TRANSCRIPT
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“Agent 59: Improving patient
experience through technology.”
Claire DurkanClinical Nurse Specialist/Team Leader
Sheffield Teaching Hospitals NHS Foundation Trust.
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Sheffield Teaching Hospitals Anticoagulation
Service• Nurse led service delivered from an outpatient clinic in the Royal
Hallamshire Hospital, Sheffield.
• Anticoagulation and VTE team; plus In-Reach service at Northern General.
• As at September 2016:
o in excess of 2,900 active patients
o managing around 38,021 ‘attendances’/year (678 new ACC; 1350 new VTE; 35,993 f/up)
o between 250 and 300 patients dosed each day
o an average of 70 referrals received each week
• Mixture of clinics – Post & dose; finger prick; new starter counselling; bridging; VTE Specialist nurses see all newly diagnosed VTE’s.
• Helpline Service – average of 90 incoming calls per day.
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Department Structure
Haematologist
(Clinical lead)
Matron
(Professional lead)
Anticoag CNS
(0.9 WTE)
Anticoag practitioners
(6.0WTE)
Clinical support workers
(1.0WTE)
VTE CNS
(1.9WTE)
VTE practitioner
(0.6WTE)
In-reach CNS
(1.6WTE)
Clerical Team
Specialist
Pharmacists
Clerical
Manager
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Clinic activity
Dosing/New patients (August
2016, daily figures)
Post and Dose
Coaguchek/face to
face dosing
New Starter
counselling - ACC
New Starter
Counselling - VTE
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Microsystems Analysis
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Main Issues
• Answerphone system in place for patient queries
• Patient complaints
• Poor message quality and “missed” messages.
When we need to ask
anti-coagulation
questions, there is no
specialist here to help.
No-one answers the phone at
the Hallamshire. The
answerphone is straight on
and no-one rings back.
When I ring up to speak
to someone it’s always
an answer machine.
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Outcome of Call
Unanswered
, 34, 31%
Src Int, 41,
38%
Answered,
33, 31%
Phone calls from Respiratory Wards April 2013
• Ward dissatisfaction.
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Solution
�Agent 59 – Integrated phone system used in conjunction with DAWN
�Went live January 2014
�Aims:�to improve the number of calls dealt with and by
appropriate member of staff.
� to decrease the number of unanswered ‘in hours’ calls to the “clinical line”.
� to decrease the number of unanswered ‘in hours’ calls to the “patient line”.
� to decrease the number of patients phoning the clinic out-of-hours to 0% (e.g. for advice on bleeding).
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Implementation• Installed by IT and Telecoms Department.
Log in’s
provided to
all staff.
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Theme 2: Service User Queries & Advice
Associated Specific Aim 4: We aim to decrease the number of patients phoning the Clinic
out-of-hours (eg for advice on bleeding) to 0% by 30 April 2013
• Answerphone service removed
• Message with clear instructions for care added for when
calls come in out of hours
• Call centre evidences huge decrease in patient numbers
calling out-of-hours
• Patients now provided with the information they need
at the time
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Agent 59 – Live data capture
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Anticoagulation Call
Centre Script
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Audit data from Agent 59
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Audit data (continued)
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Feedback• Patients
– Avoids engaged tone
– Know a nurse will ring them back.
– Speak to the right person at right time.
– Important for introduction of Coaguchek self test patients.
• Staff – Easier to manage, less frantic than answerphone.
– Able to see what type of calls dealt with and review message if we forget a name.
– Not infallible
• November 2015– inpatient ward staff survey poor feedback re contact centre – Further service improvement.
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Patient
Name
and
Hospital
Number
60 Calls received on this day
Clerical staff
member taking call
Brief Summary
in quick notes.Nurse
Practitioner
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DAWN Communication Tools• Contacts tab
• Fax header prints off reminders on dosing.
• Link with PAS system –admissions/discharges/updating addresses.
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Future plans
• Email communications – small trial with
intermediate care agencies – nhs net email.
• System for self test patients to email in their
results and populate DAWN automatically.
• Text message reminders of appointment date.
• Automatic link to “call patient” button?
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